What is Emotionally-Focused Couples Therapy?

Tuesday, April 08, 2014 @ 4:12 PM

Emotionally-focused couple therapy (EFT) was developed by Susan Johnson and Les Greenberg in the early 1980s. Emotionally focused couple therapy is an integrative approach consisting of experiential, systemic, and attachment models (Johnson, 2004). It was developed to draw attention to the importance of emotion as a powerful and key change agent in couple therapy at a time when most therapies were focusing on cognitive and behavioral techniques (Bradley, 2001).

EFT views emotions as centrally important in the experience in order for therapeutic change to take place. From the EFT perspective change occurs by means of awareness, regulation, reflection, and transformation of emotion taking place within the context of an empathetically attuned relationship (Johnson, 2004). EFT works on the basic principle that people must first arrive at a place before they can leave it (Johnson et. al., 2005).

Therefore, in EFT an important goal is to arrive at the live experience of an unhelpful emotion such as guilt and fear in order for change to occur. This adjustment happens when the client accesses their primary emotions in the session. In EFT the aim is to create a new relationship event to act as a transformer and thereby change reactive emotion with positive emotions of attachment (Johnson & Greenberg, 1985).According to Johnson (2008), there are several critical components of experiential therapies that are used in EFT.

In addition, she also strongly believes in the healing power of the therapeutic alliance. A positive relationship between client and counselor may be one of the most important, and most frequently overlooked, variables for predicting client response to an intervention (Johnson, 2004). Most experts and therapists believe that this alliance accounts for more variance in treatment outcomes than any single client characteristic. Extensive studies on the effects of the therapeutic alliance and researchers have found that establishing a helping alliance and having good interpersonal skills are more important than professional training in achieving positive treatment outcomes (Greenberg & Johnson, 1988).

Another key component to EFT as an experiential therapy is the importance of accepting and validating one partner’s experience without invalidating or marginalizing the experience of the other (Johnson, 2008). For adults, a romantic attachment is supposed to be the primary and most important human relationship in which they find a safe haven and secure attachment (Hart & Morris, 2003). The emotional process that creates the romantic attachment needs are highlighted and described to EFT couples. Education about attachment styles and the underlying role this plays in a marriage is an important component to this type of therapy (Cassidy, 2000). While a child requires the physical proximity and closeness to feel secure in an attachment relationship, adults in a romantic relationship can have felt-security from a perception of availability, even if they are not in the presence of their partner (Hazan & Shaver, 1994).

The mother–child bond is the primary force in infant development, according to the attachment theory pioneered by English psychiatrist John Bowlby and American psychologist Mary Ainsworth. Bowlby additionally proposed that when deprived of this relationship through separation and loss, the resulting fear, anxiety and distress has a deleterious and long-lasting effect on the infants overall physical and psychological development (Bretherton, 1992). Secure attachment results when infant/adult interactions create a bond in their relationship. An infant feels safe and understood when the mother responds to their cries and accurately interprets their changing needs. Unsuccessful or insecure attachment occurs when there is a failure in this communication of feelings.             

Emotionally focused therapists and experiential therapists share an assumption that every individual has the ability to make healthy and creative choices when presented with the opportunity (Johnson, 2008). When couples enter therapy, partners have often experienced considerable emotional distress.  They report feeling absorbed in negativity toward their partner and trapped in limited ways of relating to one another.  The person they used to turn to for comfort and support no longer seems available.  Some may react to their distress through blame and criticism, others through distance and withdrawal.  Research has indicated that distressed couples report lower levels of adjustment and satisfaction (Collins & Read, 1994; Simpson, 1990), lower levels of intimacy and trust, and higher levels of defensiveness, hypervigilance, and fear of abandonment than non-distressed couples (Hazan & Shaver, 1987).

Lower levels of intimacy, trust, and relationship satisfaction often indicate insecure attachment bonds (Hazan & Shaver, 1987).  Couples with insecure attachment bonds tend to interact through defensive emotional patterns and block change.

EFT is considered one of the well-substantiated therapies with well-designed studies backing it up as having isolated necessary and unique factors of change in therapy. It’s been shown to be an effective treatment for couples and families facing sexual abuse histories, depression, grief, management of chronic illness, eating disorders, and PTSD. Cloutier et al. (2002) found 62% improved at termination, but 77% improve at the two year follow-up (an increase of 15%).

EFT, Attachment and Biblical Implications

Research in this area has sought to address the question of whether people’s attachment styles which can described as secure, anxious, and distant with God is similar to their attachment styles with human attachments figures. Or, this could be opposite where a secure attachment to God is thought to somehow compensate for insecure human attachments. Studies have demonstrated that in answering this question, we must distinguish between people’s experience of God (implicit level) and people’s beliefs and behaviors (explicit level). When it comes to experience, the evidence suggests that people’s attachment to God is typically very similar to their human attachments (Kirkpatrick, 1997). These results provide important implications for spiritual formation, instruction and discipline of people inside and outside the walls of the Church.

In his research, Kirkpatrick (1997), found evidence that God may serve as a compensatory attachment figure for individuals displaying insecure attachment patterns. This study provides counselors with positive motives to integrate Christianity and an experience with a living God into their practice.

In Proverbs 1:32-33 the Bible reminds us, “but whoever listens to me will live in safety and be at ease, without fear of harm” (New International Version). Clients who have experienced hurt, rejection and abandonment from people on earth can begin to heal through the touch of God in their lives. As Christian counselors we can promote and bridge a safe relationship where God promises in Psalm 147:3 to “heal the brokenhearted and bind up their wounds” (New International Version).

Clinton and Sibcy (2006) describe the dynamics of this change in their book, ”Why you do the things you do – The Secret to Healthy Relationships” where they write,

“I had never felt loved or connected to another person in any relationship. At least not until I received the Lord. I started reading the Bible and learning about God and His ways. I came to see that He is a God who loves us more than we can imagine. I was amazed to learn that he loves even me. And although I had always lived to penetrate my brokenness and take all those negative emotions away. God’s love made me whole”.

These authors go on to contend that people will never be completely whole in their lives without an understanding of God’s love.

Emotion-Focused Couples Therapy contends that emotions are the glue of which life is made. Because human emotions are biologically based, they are then intertwined with people’s beliefs, expectations, thoughts and experiences. Helping clients understand and process their real emotions through a Biblical lens provides a means for hope and healing. Primary emotions are the healthy, core feelings that are necessary to life itself and often cross cultural. However, secondary emotions tend to be reactions and occur when we feel overwhelmed or aren’t quite sure what we’re really feeling is safe. For example, Jesus was angry in response to violation of injustice. Overwhelming anger as expressed as a secondary emotion can instead make us anxious, numb, explosive, compliant or fearful. It is the misunderstanding of secondary emotions that can become a deterrent to communication (Hart & Morris, 2003). By identifying these types of interactions, partners can get some objectivity and begin to understand the motivating factors instead of getting caught up in the details.                                                

In her training manual, Susan Johnson states that emotion in EFT is viewed as a verb (Johnson, 2004). She describes it as an active, ongoing construction, created by an individual from elements such as perceptions, bodily sensations, thoughts, meanings and action tendencies (Johnson, 2004). Healthy communication, in turn, creates a sense of connection (Gottman & DeClaire, 2001). When people feel connected, they then get along and are capable of sharing in life's joys and burdens. According to his therapy, the more couples allow this to happens, the more satisfying their relationships can become. In addition to these processes, the softening of a harsh critic, a new view of the other, learning the art of letting go and forgiving have also been shown to be effective in resolving specific emotional problems (Enright & North, 1998). Emotional processing of relationships suggests that most couples get together for emotional reasons and split up for emotional reasons making Emotion Focused Therapy an important tool in understanding these relationships

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